Showing papers by "Bryan Burmeister published in 1995"

Radiation therapy for nodal disease in malignant melanoma.

Abstract: Radiation therapy has been widely used for palliative management of inoperable metastatic malignant melanoma. For patients with nodal disease, response rates of approximately 70% have been reported. There are limited data concerning the role of adjuvant irradiation following therapeutic lymph node dissection. In this review, 57 patients with isolated resectable and nonresectable nodal disease have been treated with radiation. The overall response rate is 84% for bulky disease. Large fractions are beneficial. The median disease-free survivals were 11 months after adjuvant treatment and 7 months for those with inoperable disease. The median overall survivals were 20 months and 18 months, respectively. Local control in long-term survivors was excellent. Sixty-five percent of patients developed distant metastases. There is a need for additional studies with the use of adjuvant radiation therapy following lymph node dissection.

Combined modality therapy for esophageal carcinoma: preliminary results from a large Australasian multicenter study

Abstract: Purpose: Thii report updates local control and survival experience and focuses on treatment toxicity in 294 patients with esophageal cancer who have been treated at six Australasian centers using three prospective unrandomized protocols that used concurrent radiation, cisplatin, and modest dose infusional fluorouracii. Methods and Materials: Protocol l--“ definitive” chemoradiation. One hundred and thirty-seven patients have been treated with “definitive” radiation to 60 Gy in 6 weeks plus two courses of cisplatin (80 mg/m’) and infusional fluorouracil (800 mg/m’/day over 4 days) during the first and fourth weeks of radiation. Protocol 2--” preoperative” chemoradiation and surgery. Seventy-eight patients received chemoradiation using the same chemotherapy, but 30-35 Gy in 3-4 weeks prior to surgery. Protocol 3-“palliative” chemoradiation. Seventy-nine patients deemed incurable were treated “palliatively” with the same chemoradiation protocol without surgery. Follow-up ranges from 6 months to 7 years (mean 22 months) in live patients. Results: Durable palliation of dysphagia in all three treatment groups has been reflected by encouraging 3-year survival expectations of 43.2 + 5 % in dethtitively treated patients, 40.3 2 7.65% in surgically treated patients, and 8.5% ? 3.9% in the palliatively treated patients. There are early indications that female patients have fared better than males. Toxicity levels were modest in all three groups. Following definitive treatment, severe myelotoxicity (World Health Organization grades 3 and 4) occurred in 19%, severe esophagitis (World Health Organization grade 3) in ll%, and moderate or severe benign stricture in 17%, depending upon age and sex of the patient (being worse in female patients). Conclusions: These studies demonstrate that the concurrent addition of modest dose cisplatin and infusional dose fluorouracil to radiation in the definitive, preoperative, and palliative settings contribute to high rates of durable dysphagia-free survival, with overall survival comparable to (and possibly better than) the chemoradiation arm of the recently reported Intergroup Study, but at the cost of less morbidity. Esophageal cancer, Combined modality therapy, Chemoradiation.